Emerge Advocacy: support and advocacy for young people who self-harm, guest blog post

Joy has been a youth worker in the Midlands and South East for the last 16 years. Having faced her own struggles with mental health she has a particular passion for working with young people in this area. Joy is a mum of three and would love to go running more often!

The idea for Emerge came into my brain around 2 years ago, having just spent many hours on a ward supporting a young lady who is very dear to me – I have been her youth worker for the last 4 years. During her time in hospital (this time from an overdose) there were a number of key things I found myself doing which, on reflection, I wondered who would do these things for other young people if they didn’t have someone in a youth-worker-type role.

Firstly, I should explain what is unique about being a youth worker. The great thing about it is that you’re simply there for the young person. As a youth worker, you are not there to assess them, to treat them or to make them do anything. You’re also not so emotionally invested as family and are more experienced in life than their mate from school. Youth work is about listening, supporting, empowering, facilitating and most of all it’s voluntary. The young person has no obligation to speak to me as a youth worker. They can tell me to get lost and I’ll go.

So what were the things I found myself able to do because of this role?

Firstly, because I was informal and non-clinical, the young person was relaxed. We both understood the boundaries of confidentiality and she could chat freely with me. Our conversation had no agenda and we would roam from discussing the latest events on her favourite soap, to her telling me some of her deepest and darkest thoughts, and then we’d drink tea and talk about hair straighteners.

Secondly, because I had a good understanding of the process she was in with regards to her admission, I could be a useful source of information and reassurance to her. I could tell her which professionals she would be meeting and give her a heads up about the types of questions they might ask. This gave her space to think about what to say beforehand and, as someone who found articulating her feelings difficult, this was really helpful in reducing anxiety and helping her have useful conversations with professionals during assessments.

Thirdly, and most surprisingly to me, I was welcomed by the young person’s family and taken seriously by staff – including CAMHS, who would ask what I thought about her situation, her risk, her protective factors etc. I was actively included in assessments, discharge planning meetings and discussions between CAMHS, social services and the family. While I didn’t always say much, my task in those meetings was to keep in mind all I knew of the young person, her needs, fears and wishes, and try to help her express these to the people making the decisions about her care.

Finally, because of the scope of my role, I was able to give continuity of support between hospital and home, meeting up with her to check in, catch up and talk through what was happening next. It was difficult for her to engage with CAMHS because she found talking so difficult and the clinical nature of the environment made her very anxious. I was able to smooth the way for her by talking with her CAMHS worker about what may be helpful or less helpful for her during sessions, good ways to engage her etc. I was even able to go with her for moral support and I found that again, although I didn’t say much at all, my presence there helped reassure her to begin to engage with her therapist. As time went by I was able to withdraw.

So that’s what I did, it was one person, but it got me thinking about the many other young people who find themselves in similar circumstances. I wondered whether it would be possible to offer this kind of informal yet informed support to bring comfort and some light relief, as well as being a sturdy friend in the darkest of times. This, always with a vision for seeing the young person come through those times, into stability and enjoyment of life.

As these ideas bubbled around inside me I started tentatively sharing them with others who, much to my surprise didn’t tell me I was being ridiculous, but put me in touch with key people in my local health authority. It’s been a long process of thinking, and talking, writing policies, having meetings and building team, but now we have a youth work service in the Royal Surrey that runs until 11pm six days a week. We offer support in A&E and on the wards for people aged 14 – 21 who present with self-harm, overdose, low mood etc. We are called Emerge Advocacy.

We are still feeling our way but we are starting to get feedback from young people who say things like ‘My Emerge worker was always there when I needed her, she understood me when I felt suffocated by my family’. And nurses who say things like ‘My team feel reassured when we know that Emerge are working with a patient. It’s great to know they have someone they can really talk to’.

I would love to hear from anyone doing similar work who we can learn and share with. It’s a bit of an adventure but I hope one day that every hospital might have a team of youth workers who can be that tea making, chit chatting, deeply discussing, informal yet informed friend who holds the hope for young people when they just can’t hold it themselves.

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Comments

This sounds totally amazing! I used to work for camhs in Blackpool and can really see how much of a need there is for this kind of youth work service on all hospitals as the process of hospital admission for self harm and attempted can be such a frightening experience for the young person. Great stuff Joy!